Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta University, Augusta, GA.
Medical College of Georgia, Augusta University, Augusta, GA.
Int Forum Allergy Rhinol. 2019 Jul;9(7):821-824. doi: 10.1002/alr.22307. Epub 2019 Feb 4.
We previously showed that the supraorbital ethmoid cell (SOEC) is a reliable landmark for identifying the anterior ethmoid artery (AEA). Recent data have suggested that Keros classification is also a dependable predictor. We aim to characterize the location of the AEA and its relation to the skull base in patients with and without SOEC using the Keros classification.
Retrospective radiographic evaluation of computed tomography (CT) scans of 76 patients (40 with SOEC, 36 without) was conducted. Distance of AEA from skull base and prevalence of AEA outside of the skull base were measured on each side and compared between groups using the 2-sample t test and χ test, respectively. Subgroup analysis was carried out based on the Keros classification.
Mean distance of AEA from the skull base was 1.32 ± 1.5 mm in patients with SOEC and 0.47 ± 1.08 mm in those without (p < 0.001). Prevalence of AEA outside of the skull base was 53.8% in those with SOEC and 18.1% in those without (p < 0.001). Comparing patients with SOEC to those without, AEA was found below the skull base in 30% vs 0% of cases with Keros type 1 (p = 0.45), 58% vs 14.5% with Keros type 2 (p < 0.001), and 60% vs 50% with Keros type 3 (p = 0.72).
The presence of SOEC is associated with a higher prevalence of the AEA coursing below the level of the skull base in all Keros types, thus placing the artery at greater risk for injury. Careful surgical planning is needed to avoid potential orbital complications.
我们之前的研究表明，眶筛前细胞（SOEC）是识别筛前动脉（AEA）的可靠标志。最近的数据表明，Keros 分类也是一个可靠的预测指标。我们旨在使用 Keros 分类来描述具有和不具有 SOEC 的患者中 AEA 的位置及其与颅底的关系。
对 76 例患者（40 例具有 SOEC，36 例不具有）的计算机断层扫描（CT）扫描进行回顾性放射学评估。在每一侧测量 AEA 距颅底的距离以及 AEA 位于颅底外的发生率，并分别使用两样本 t 检验和 χ 检验进行组间比较。根据 Keros 分类进行亚组分析。
具有 SOEC 的患者中 AEA 距颅底的平均距离为 1.32±1.5mm，而不具有 SOEC 的患者为 0.47±1.08mm（p<0.001）。具有 SOEC 的患者中 AEA 位于颅底外的发生率为 53.8%，而不具有 SOEC 的患者为 18.1%（p<0.001）。与不具有 SOEC 的患者相比，在 Keros 1 型中，AEA 位于颅底以下的病例在具有 SOEC 的患者中占 30%，而在不具有 SOEC 的患者中占 0%（p=0.45）；在 Keros 2 型中，AEA 位于颅底以下的病例在具有 SOEC 的患者中占 58%，而在不具有 SOEC 的患者中占 14.5%（p<0.001）；在 Keros 3 型中，AEA 位于颅底以下的病例在具有 SOEC 的患者中占 60%，而在不具有 SOEC 的患者中占 50%（p=0.72）。
SOEC 的存在与所有 Keros 类型中 AEA 位于颅底以下的发生率较高相关，从而使动脉更容易受伤。需要仔细的手术计划以避免潜在的眶部并发症。
